Who are the middle adolescents or teenagers? They are kids ages 15-18 and they undergo physical growth and personality changes. With their obvious biological transformation comes the self-concept. So how do these teenagers perceive themselves?

- Identity formation is really intense. Kids usually experiment with various roles, such as looks, friendship, etc.
- Girls may resort to dieting, or worst yet, eating disorder because they want to have a certain type of body.

Normally, teenagers tend to copy other kids, particularly what they see on TV. Clothes, music, and even expressions. Most of the time, this makes it hard for parents to accept or to say something about the changes with their teenagers. Peer pressure becomes very apparent when they emphasize that their friends are more important more than anything else. But, the real issue about this matter is when kids come across bad influences.

Cutting may be the most common way of self-injury, but there are a lot of types such as the following:

• Piercing the skin with sharp objects
• Head banging
• Burning
• Poisoning or overdosing
• Scratching
• Pulling out hair
• Interfering with wound healing
• Pinching
• Biting
• Carving words or symbols on the skin
• Breaking bones
• Hitting or punching

Take note that self-injury is not a suicide attempt The kid does not necessarily intend to kill one’s self, but instead cause harm to the body.

Cutting takes a whole different meaning when teenagers associate it with emotional pain. Cutting has been a way to stop their so-called unbearable issues. It is actually self-injury, which results from invalidation. Perhaps kids are made to believe that their interpretation of feelings is wrong or bad. In short, they are not allowed to feel that way so they have to punish themselves by cutting. Most of the time, their parents, guardians or any family members have formerly severely punished them for expression of such feelings and thoughts.

When anxiety in teenagers strikes, it is more likely caused by genetics and the environment, particularly the one they had as children. Thus, such as a condition usually result to depression. Anxiety usually brought about by several stress factors like:

- Neglect of parents
- No emotional support from parents
- Academic expectations
- Family responsibility
- Tension at home

Counselors and therapists as well as medical and mental health professionals are not necessarily more qualified to evaluate and deal with a risk of suicide than a reasonable person.

Physicians are trained to diagnose and treat medical conditions, medicate if necessary, and admit patients to holding or psychiatric facilities. Evaluation, intervention and treatment of a suicide risk are specialized skills that require training and supervised experience.

Program personnel should consider themselves responsible for the outcome, when that program and their staff assume the authority to intervene or dismiss the risk of suicide.

The evaluation of a suicide risk is in fact an intervention and that intervention should not end once the child’s risk is no longer considered immediate. Consultation with parents and obtaining second opinions from qualified professionals are reasonable standards of practice.

A minimally qualified professional to deal with a suicide risk would have:

~  a masters degree in a mental health field,
~  licensure in a mental health field,
~ 16 hours of continuing education training in crisis intervention (with emphasis on suicide and violence risk), and
~ 6 months of supervised experience and training working with suicidal adults and children on regular basis.

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Failure to recognize Borderline Personality Traits (BPT) in a wilderness program can lead to chronic problems and can have a destructive impact on a child’s life. Many  students with the initial behavioral symptoms of this disorder will go undetected primarily because they hide these behaviors from parents and family members.

They are generally not evident until the child is under stress and they are observed continuously in a structured setting such as a therapeutic boarding school, psychiatric hospital, residential treatment or wilderness program.

In a wilderness program, a student may not demonstrate all of their symptoms until the third or fourth week. In severe cases they will be uncompensated within a week.

Behaviors That Will Be Encountered In The Field:

~ Intense emotional pain (shame, guilt, fear, loneliness, emptiness, longing)

~ Rapid mood swings (anger, sad, fearful to happy).

~ Failure by others to meet their needs are interpreted and reported to others as personal, intentional, neglectful or abusive.
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